MITIGATING THE FINANCIAL DOWNSIDE OF VALUE-BASED CARE



MITIGATING THE FINANCIAL DOWNSIDE OF VALUE-BASED CARE

6.4.2020 : MITIGATING THE FINANCIAL DOWNSIDE OF VALUE-BASED CARE

As the healthcare ecosystem continues its transition from a traditional fee-for-service, volume orientation to one of value-based care, payment models between providers and payers are driving the change. Medicare, Medicaid and private insurers share a common goal: to engage in contracts where there are potential economic financial benefits and downside risks to hospitals, health systems and physicians. These two-sided arrangements can take many different forms, but ultimately involve elements of large claim mitigation, and population health management measured against financial and quality benchmarks. Stop-loss protection and reinsurance are two important solutions available to providers as part of an effective enterprise risk management strategy.





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